Schema therapy

One of the bonuses of working in my centre is the array of opportunities to get training, and i consider it my excellent fortune to have met very good trainers who are very much into accepting the client and you can tell that their work comes from their heart, who they genuinely are as persons, and not just professionals trying to do their job.

These 3 days i have been learning from Dr Jeffrey Young, the founder (or one of the leading experts?) of Schema Therapy, which is an integrative therapy that combines cognitive therapy, emotion-focused therapy, attachment theory, Gestalt, and others that i can’t rem off hand but those mentioned are the main ones. What i really liked about this therapy is that it takes the best of cognitive therapy and complements it with a therapist stance of validating the client’s emotions, hence, making therapy something that the client can really relate to, instead of an abstract, philosophical, cognitive-focused kind of therapy that is usually seen in cognitive therapy where the client might see the distortions in his cognitions, but cannot genuinely believe a more accurate way of thinking cos of what his emotions/schemas tell him.

In schema therapy, cognitive distortions are always explained by relating examples from client’s history, and there is a lot of validation of his emotions, so that the client doesn’t feel like the therapist is challenging him in a judgmental, critical way. This is why the dropout rates in schema therapy, as shown in outcome studies, are extremely low compared to other kinds of therapy, and the success rate is also relatively high. I also like the heavy use of imagery work in this form of therapy, which is done in diff ways e.g. have the client recognise the different parts of himself, dialogue between those diff parts, as well as confront the negative modes (schema tech language) such as the Punitive Parent. Lots of videos of therapy with actual clients were presented and i cld see how powerful and transformative the imagery work can be for the clients – a part of me was so impressed and amazed by it, while another part of me wondered when would i ever have the skills and qualities to be able to do therapy to such depth.

In fact, these 3 days really made me realise how little i know and how much there is for me to learn in the world of therapy. Most of the participants are definitely experienced helping professionals, from the questions raised, and while Dr Young always kept his language very simple and clear, his evidently extensive experience and knowledge definitely made me feel very much like a greenhorn in both of these areas. Of cos, this realisation is a good one, cos it would prob motivate me to study and practice harder, instead of complacently thinking that i’m good enough already.

And it’s not just experience and knowledge that i now know that i’m very much lacking in, it’s also the amt of inner work that i still need to do in order to be a truly good therapist. In the first day we were introduced to the 18 main maladaptive schemas (the filters through which we view ourselves and the world, and which make us think, feel, and behave in certain ways) and i was like, gosh, seems like i have over half of them. Well, maybe i was also being slightly neurotic cos on the 2nd day i did the schema inventory on the way to the course, and it turned out that i only scored high and very high on a total of 3 schemas. However, i was doing it on the bus, and since schemas are also contextual, in other words, there was nothing in my environment to trigger any schemas that i may have, perhaps the scores weren’t too accurate. It’s true that my behaviour at work is very mature and healthy (which is why my colleagues all have gd impressions of me), while it’s at home where i become a different person altogether (which is why Mr Gua Gua can get a tough time at home…. :P), so perhaps if i were to do the inventory at home after some upsetting incident and specifically with regards to Mr Gua Gua, i wld prob uncover even more schemas in me. Guess it’s not a very uncommonly known fact that partners can bring out the worst sides in each other… and perhaps that’s how we force each other to grow spiritually!

Anyway, it’s enlightening to read about these schemas and be aware that i may have some of them, cos then i will be more cautious about whether clients’ own dysfunctional behaviours may trigger off my own schemas and hinder my ability to respond in a therapeutic manner. Although now i actually wish that there are schema therapists in S’pore so i can get myself into schema therapy! It’s a bit sad to discover these things in myself and not have someone who can help me to work on them. Guess i’ll have to rely on myself to work on my own stuff, and trust that the universe will send along the right persons/conditions to help me learn the lessons i need to learn in order to become a better therapist, or in fact, a better human being.

One other very interesting concept in schema therapy is that of the idea of re-parenting. Schema therapy says that clients get their maladaptive schemas mostly from parents and other early caregivers – either they were neglected (leading to schemas such as emotional deprivation, isolation, abandonment), over-indulged (leading to schemas such as entitlement, insufficient self discipline), over-protected (leading to schemas such as dependence, failure, enmeshment), disciplined too strictly (leading to schemas such as punitiveness, negativity) or lastly, accepted in a conditional manner (leading to schemas such as subjugation, self-sacrifice, approval-seeking).

What the therapist attempts to do is to be the kind of parent they never got, so as to fulfill those unmet needs (that created those maladaptive schemas), and hence allow them to mature emotionally, to eventually be able to relinguish the schemas and negative coping styles they used to protect themselves against pain and hurt. And what’s interesting about this reparenting is the extremely close relationship that the therapist tries to build with the client, which may seem counterintuitive to other therapists cos we are taught to draw boundaries with our clients and not get too close with them. However, in schema therapy, it’s the relationship btw the therapist and the client that IS the therapy – in the sense that it not only helps the client to meet their unmet needs and overcome their schemas, it also allows them to know what it’s like to have a healthy relationship with someone who can truly accept them and make them feel understood and supported.

Dr Young did point out that it doesn’t mean we have to pretend to like them even when the client is being difficult during the sessions. On the contrary, in order to build this very close relationship, it’s essential for the therapist to be honest and direct, even if it means telling the client when you do not feel very positive towards them, though of cos, it must be done in the gentlest way. This is one part of schema therapy that excites me, cos i always believe in the value of honesty and it’s also an integral part of my character to be direct and upfront (sometimes, that gets me into trouble of cos), so i’m happy to know that this is something that aids in the therapy.

I’m also very impressed by Dr Young’s attitude and manner – he speaks of his clients with the utmost respect and understanding, and in these 3 days, he has shown himself to be extremely patient, gentle and at the same time, honest about his opinions, even when it is in opposition to that of the participants, though he always makes sure that he prefaces it in a way so that the participants do not feel criticised or judged at all. There is one in particular that he was quite direct towards to, that i felt a bit of an ouch for that participant cos he actually pointed out in front of everyone that she could be hiding some of her own issues. Of cos, he didn’t phrase it in that way, and i guess he was in a way doing it almost like a supervisor, who scolds you for your own good – i sure wish he can be my supervisor… i’ll gladly be scolded by him anytime! Anyway, he was already doing it very nicely with that participant and i only felt that ouch for her cos he was doing it in front of 100 over pple, but if it was just the 2 of them, i don’t think i would feel any pain at all, if i were her.

Well, this was another trainer that taught and inspired not only in what he said, but how he said it. He truly taught by example, and i’m just very impressed by how he cld be firm without being critical, humble without being condescending, and always willing to apologise very sincerely for certain things such as not being able to understand our accents, when other trainers may joke about it in a more arrogant kinda way. It’s from his highly warm and nurturing behaviour that i grasped the idea of reparenting, and i can certainly see how easy it could be for his clients to drop their defenses and trust him deeply, no matter how deep-rooted and serious their issues are.

Another thing that excites me about schema therapy is that this may just be exactly what i was looking for to complete what i can do with EFT. What has always been a concern for me in doing EFT is the possibility of healing the client in a very superficial way, cos taking away the negative emotions, while may help the client lead a happier life, may not help them learn the lessons in those negative life experiences and evolve in their spiritual journey. I don’t know for a fact if this is true, cos a lot of articles i read on the EFT newsletter seem to show that when the negative emotions are cleared, clients are naturally able to gain insights into themselves and abt other pple in their lives. But i’m not sure if this is always the case.

What’s terrific about schema therapy is that it can help the client identify parts of them that need healing, how those parts came about, and cos the most difficult part in schema therapy is really helping the client to stop believing in those maladaptive schemas, and imagery work, while powerful, can also be a painful experience for clients who still believe negative things abt themselves. To me, EFT would be a fantastic tool to help clients release those schemas in a quick and painless way, and then use schema therapy to help them gain insight, cos it makes so much sense. In fact, it is really a pity that Dr Young prob haven’t come across EFT yet, cos i think the combination of schema therapy and EFT could be seriously dynamic. On the other hand, there is also a part of me that wonders if it is necessary for the client to go through slower types of therapy, for them to gain greater insight. In other words, does suffering = spiritual growth.

Haha, that is prob another huge dilemma that i have yet to find an answer. Cos i have believed for a long time, due to my Buddhist roots, that suffering is essential and conducive to spiritual growth. But new age spirituality exposed me to the teaching that this idea, that pain is a necessary ingredient in spiritual evolution, is an outdated teaching, and it’s actually possible to grow spiritually without having to go through pain. And i guess EFTers would agree with this teaching, as EFT is indeed a quick and painless method of healing one’s own issues.

I brought this up in supervision once, and interestingly, my supervisor who is a Buddhist, said that Buddhism does teach that life is suffering, and since that is the case, there is enough suffering for us and there’s nothing wrong with trying to lessen it. So he seems to be hinting that if we can alleviate our suffering, why not? In fact the monk who learnt EFT also said something similar – that Buddha taught us to liberate ourselves from suffering, and that’s what EFT is all about.

I guess at this point, i really don’t see anything wrong with that either. And i guess spiritual evolution is something that cannot be hindered by human efforts, except for the person himself who is on his own spiritual journey. So EFT can’t possibly make it possible for pple to bypass spiritual lessons… there’s prob no such thing, cos if a person has certain spiritual lessons to learn in this lifetime, he would be presented with the exact kind of conditons for him to learn them, and it doesn’t make sense for a self-help technique to steer them in the wrong direction?

Hmm… i don’t know if that makes sense to any of you, but it does to me, so i have happily answered my own question. Well, it’s been a real enlightening 3 days for me, and the timing is fantastic cos i haven’t been feeling confident in my work for the past week or so (“coincidentally”, my clients have also been not turning up for sessions). Now, i believe i have a newfound sense of direction for my work… and hey, there’s still the quantum hypnotherapy to look forward to this weekend! Guess the universe is making sure that i learn what i need to do my work well…. for that, i’m truly grateful.

In fact, this work also includes my work as a parent to little boy, and i guess this 3 day course has definitely enlightened me on what to do and what NOT to do to make sure he doesn’t grow up needing schema therapy in future. So i repeat again, since Mr Gua Gua will be reading this, the types of parenting that can lead to the internalization of maladaptive schemas:

1) Detached, rejecting, cold (guess this is not much of a prob for Mr Gua Gua, though i can be emotionally erratic at times which will hopefully be less frequent from now on)

3) Permissiveness, overindulgence, making child feel superior to others (the latter esp apply to Mr Gua Gua who wants little boy to be king of the world..haha…but the rest, i guess, applies to us all, both sets of grandparents included)

4) Conditional acceptance (this, unfortunately is very common in the local culture, where you often hear parents and grandparents say things like, if you do this i won’t love you anymore. I am very aware of this and try not to say such things, but even at times, i’ll be tempted to threaten little boy with my anger if he disobeys me. And i have certainly heard both his grandmothers say such things plenty of times… hopefully our love for him is enough to compensate for this kind of behaviour)

5) Demanding, punitive (luckily, none of us are like this, and even my mum who comes closest to this balances it out by being very playful and caring with him, so it’s prob not much of a prob)

Well, despite the above, i guess no matter what, there’s no such thing as a perfect parent! And now that i do know the above, i’m confident that i’ll do well enough as a parent to make sure that little boy is not going to need schema therapy in future… heehee… :)

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I have enjoyed reading your thoughts regarding Schema Therapy and your introspections, as well. I hope that S’pore will afford Schema an inroad, so that it can be applied more. Spent some time in M’sia, Thailand, and S’pore as a grad student, before returning to the USA. Reading your blog reminds me of how the people I met were such happy thinkers and selfless people, like you. It was just like having a visit with them, again, to read your commentary. It appears that you have a child who adorns your life. And what a blessing children are. We must earn their respect and do our best, by our concern for them, and cultivate their honor for good outcomes in the “scheme of things.” Much happiness and prosperity to you and your lovely family; your are a remarkable person. Thank you for your insights on Schema Therapy, as I am researching same. Completed Art Therapy and an Anthro/Art focused study at the graduate level. Two Masters, instead of digging in and getting the PhD. Dr. Young has made interesting breakthroughs, and you make a good case for further study of his methods. I look forward to learning more about it. Thanks for the info! Be well!

I found Jeff Young’s website on Schema Therapy this past winter. In reading the presentation materials, I felt like I had finally found some answers to my “treatment resistant depression”. I called his office and asked for a referral here in Ohio. There was one person they recommended, and I have been seeing him for the last few months. I feel like I am therapy for the first time (after 18 years of it) and it’s like this approach is connecting the dots I already knew. My doctor is Kevin Arnold, and I have hope for the first time.

I am having schema therapy after seven years of terrible depression and angst. It is the best thing that has ever happened to me, I am making huge inroads into understanding and changing my behaviour and importantly for the first time ever I feel understood and validated.

I can’t believe you are a practising therapist. You write like a twelve-year-old girl- cutesy text speak, run-on sentences, lack of coherence in your premise and arguments, and disorganisation of the observations you attempt to make. I know it’s a blog, but still, I feel very sorry for your clients.

Hi there! You’re right… and i enjoy writing in this way, instead of a more academic style, firstly cos this is who i am, and secondly, i think there is a group of people who understands this kind of language better. It’s ok if you hate it… i’m sure you will find “better” blogs to read, and perhaps, therapists who speak in your language. Have a nice day!

fuzzynale, or whatever you name is. Keep being the way you are. That post that you made was great and really inspirational. I think you’re a really honest but also caring person. You do stuff from your heart. And I think you’re reaction to “nOt ProFesSioNal” is good too! That was a really mature and independent way of talking to this person.

I’m making a little group on Facebook called “Schema Therapy” at the moment because I want more people to know about it. http://www.facebook.com/group.php?gid=169760713191 I find it a bit hard because I’m trying to be open and myself and talk in a way people understand but at the same time I’m afraid that I come over the wrong way. (Look at Subjugation trap, a litle bit the Self-sacrifice type but especially the submissiveness type)

I wish i could be one of her clients. Someone who writes from the heart and would connect with most people who would benefit from Schema therapy. Over the years I have had boring, everything had to be perfect type professionals and still I suffered. Then I came across such a therapist as the writer. Been working with her for the past two years and my life is being transformed.

For the first time in my life, it is 18 months since my last overdose, they use to happen most weeks, many times waking up on life support equipment. My daughter also had the same condition, she did take her life whilst in hospital. If only she could of met someone like fuzzynale, I wonder if she could of rebuilt her life.

So sorry “Not Professional” perhaps that should be “Not compassionate”.

Schema therapy can give hope to many people, let’s keep on researching for different therapies.